This post was originally written in 2020 and modified shortly after the pandemic ended in May 2023
When fears of COVID-19 heightened, non-essential personnel were asked to stay home and practice social distancing to flatten the curve. Despite this, the number of cases and deaths were increasing exponentially just showing how contagious and deadly COVID-19 really was.
In the midst of all this, one of the conversations that stirred among physical therapists were whether physical therapists were really essential or were we doing more harm than good?
Most of the discussion centered around PTs working in the outpatient setting.
When trying to understand our role in this mess, there are always going to be those that put us down but don’t mind them. There’s usually a rational voice to make some counterpoints. In this case, a few:
Where do I stand?
If you haven’t learned about me yet, I’m a little bit of a workaholic and I enjoy getting paid to help people move better. Even after I paid off my 6-figure student loan, I got used to bouncing between two jobs even on those 12 hour days. It kept me busy, but all good things don’t last forever.
The outpatient facility where I did PRN work closed down in early 2020 due to the pandemic. During that time, I was thankful that I still had my full-time position working in the home-care setting, but it wasn’t going well either since patients were cancelling left and right and honestly, I didn’t feel too safe doing home visits myself.
With that being the case, I asked myself whether my work was really essential at least during a global pandemic. While scouring forums and Facebook groups, it was evident that I wasn’t alone.
I think most people would agree that PT in hospitals and rehab facilities are more “essential” since they work with sicker patients, but what about PT in other settings?
Were Outpatient Physical Therapists Essential?
While PTs are generally recognized as essential personnel by the organizations that govern us, it is clear that the majority of outpatient PT services can wait. Yet, outpatient therapists were wondering why they were still at work placing bets on whether or not their next patient will show up.
Some outpatient clinics have taken the initiative to close to protect the public, while others have chosen to find creative ways to keep their lights on until they can no longer do so.
Physical Therapists may be essential on paper, but in the outpatient setting the supply-demand curve would suggest otherwise with empty schedule books.
Was Home Health Care Physical Therapy Essential?
As far as home health care, I was seeing similar things happening. My caseload is gradually shrank as both myself and my patients were hesitant in exposing ourselves.
On top of difficulty maintaining my current case load, we were seeing 30-40% fewer referrals. From what I heard, this happened across many home health care agencies. This is because people were avoiding hospitals at all costs and avoiding elective surgeries altogether. Physicians were also being more selective about who they sent to the ER. People were also generally moving around less meaning fewer chances for accidents and altercations.
Of course, this meant the patients I was seeing were the sickest of the sick. They were at high risk for hospitalization. At that time, I did feel home health care is essential in minimizing rehospitalizations and PTs play a role. However, we have to modify our approach to care as suggested by a statement released by the APTA.
As the death toll rose, it wasn’t really a question of what was essential, but what was urgent. It was increasingly important to use professional judgment while weighing the risks and benefits of not only our interventions, but also our involvement altogether.
After all, we are essentially part of a team
Whatever your job title or setting was, you were essential. Essential in the sense that you were important in keeping the public safe even if it meant staying home.
Even if the powers that be have deemed your work “non-essential,” you were still essential. Again, essential in the sense that you’re trying to do the right thing.
For me, the right thing meant trying to keep patients out of the hospital. It meant taking a pay cut and stay home to avoid disease spread. It meant making more telephone calls and impromptu telemedicine even without fair pay. It meant making sure my patients understood that they’re not out of the woods yet. It meant more unpaid drives to my main office to restock on PPE and sanitation supplies.
All the extra work during that time did not come with extra compensation. The extra stress and risks I took by being out there did not lead to any awards and neither would kicking back and doing nothing.
The result was it’s own reward. We made the best choices with the information we had given our situation. We all made sacrifices during that time and we stuck together even if we did so while being further apart. So yes, for the most part, physical therapists are essential, just not urgent.
